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[applejack]

Hi

so I got my scan results today but it's all a bit confusing.

I stopped taking HRT end of October after starting a heavy period.  After about 26 days off HRT bingo, another period.

The period started on the day I had my scan last week, with great timing. 

The result came back as 'endometrial lining outside normal thickness range'.  Uh oh.  So there I was panicking, but the doc said no, you've been off HRT for a month, it's only outside normal for someone who is actually taking HRT.

Which is fine, but I was ON HRT last month when I had the first period.  It was flippin' heavy so that lining would have shown up on a scan if I'd had one then too.  I forgot to mention this at the time.

She also said I might have another period even though I've been off HRT for 30 days now, which I was kind of expecting. 

Nothing else showed up as abnormal.  But I'm mightily confused. 

[Dancinggirl]

I have to say the resukts the doctor gave youbdont make sense to me??!! If the lining is thickened ( therefore outside normal range) and you have been off HRT for over 4 weeks, then this build up must be from your own hormone production. I therefore assume you are still peri menopausal then??!! You must be producing oestrogen yourself to have the lining build up and cause a bleed without HRT. 
Did you think you were post meno? DG x

[applejack]

From apr 2016 to Jun 2017 when I went on HRT, I didn't have a period although I had some spotting in Nov 2016.

If the spotting counts, then I went on HRT too soon. If it doesn't count then I had 14 months period free before starting HRT.

[Dancinggirl]

Applejack
The peri stage can be tricky - periods can come and go, sometimes with long gaps between. Spotting would count as a period I'm afraid,  as light or heavy periods are also common in peri.
Also, if you are under 54, then to be officially post meno you need to go 2 years without a period. HRT in-the peri stage can be very beneficial to help balance the hormones while they are fluctuating but you would need a sequi HRT which brings a regular bleed each month to protect the uterus and stop it building up.
What type of HRT were you taking? If you were put on a conti HRT while still peri, then this would result in heavy and erratic bleeding. The fact you have had a bleed around 4 weeks after stopping HRT would probably indictate your ovaries are still functioning a bit but probably erratically.
It is awful that women are taught about puberty but not told what happens and what to expect when menopause starts.
Hope that all makes sense.
If you want to use HRT again, then you should use a sequential HRT. DG x

[applejack]

Conti, and I think you are right.  Doc said spotting  didn't count but... something has to trigger it. I did wonder.

Ok so, could I start on a sequi now?   How do you work out when to start with it when you don't have a steady cycle anymore? 

So right about education. I'm old enough to remember when periods were taboo. Much better now. Menopause is still “embarrassing” although I also think that will change too.

[Dancinggirl]

Applejack - I would ask for a sequi HRT like Femoston 1/10 (has gentler progesterone so tolerated well) and I think it is often best to start it a couple days into a bleed if you still have them but if you don't get a bleed then I believe you can just start the HRT any time. Many women find they prefer to be on a sequi HRT well into post meno as it means less time in progesterone. Even if post meno, it's usually better to start with a sequi HRT type first to see if the progesterone suits.
If you were on Elleste conti before, then try the Elleste Duet sequi 1/10 version.
DG x

[applejack]

I was on femoston conti but I know they do a sequi as well.  If you can take it post meno too then sounds like it covers both bases. 

I'm going to give it another month and then go back.  Things may have settled down by then, but if not and I'm having a regular bleed then that probably proves that sequi is the way to go.

Amazed at how much knowledge you have.  I'm beginning to understand just how complex it is.  I know doctors have general expertise but this area is really tricky to get right as there are so many factors.

[Dancinggirl]

I wouldn't try the conti again yet - use the sequi for at least another year before moving to conti again. Femoston is a good HRT for many women as the progesterone is gentler so is tolerated well. . DG x

[Hurdity]

Hi there

Just to say in addition to Dancinggirl's very helpful advice, that the Femoston conti does not come higher than 1 mg oestrogen so if you need higher than this, and started now on Femoston 2/10 but then wanted to change to conti HRT - you would need a different type - with a different progestogen - if you see what I mean  (ie there is no Femoston conti 2 mg)? Elleste conti only comes as 2 mg ( but there is a 1 mg hRT with the same progestogen called Kliovance. If you want to see all the different types of conti HRT they are here:
https://www.menopausematters.co.uk/postmeno.php

and the sequi ones ( for peri-menopause or those who don't want to takre progestogens all the time):
https://www.menopausematters.co.uk/perimeno.php

Also to clarify the diagnosis of menopause - for the purposes of knowing when to investigate bleeding or to decide when you are post-menopause - the timescale is 12 months without a period at any age. This is to ensure any instances of cancer don't get missed and all bleeding after 12 months have elapsed ( in the absence of taking HRT) is investigated.

However if you are under 50 then contraception needs to be continued for two years following the last period, but over 50 only one year  - in recognition of the fact that younger women may be more likely to restart ovulation even after 12 months without a period. The average age of menopause is 51/52.

54 is the age at which (according to the info on this site) 80% of women have reached menopause, and when women can try out continuous combined HRT if they have been on sequi HRT for some time.

This information can be found here:
https://www.menopausematters.co.uk/menopause.php
https://www.menopausematters.co.uk/contrastop.php

Hope this helps

Hurdity x

[applejack]

Thank you so much  xx